Health overhaul moves toward first Senate vote on amendment on women’s preventive services

Senate pushes toward first votes on health care

WASHINGTON — The Senate pushed toward the first votes on sweeping health overhaul legislation Tuesday amid rancorous debate over whether the bill would repair the nation’s safety net or bankrupt the country.

Despite the partisan back-and-forth the first amendment offered was bipartisan, a measure to increase preventive care for women co-sponsored by Sens. Barbara Mikulski, D-Md., and Olympia Snowe, R-Maine. Snowe was the only Senate Republican to vote in favor of Democrats’ health care legislation in committee.

Their amendment would give the Health and Human Services secretary authority to require health plans to cover additional preventive services for women and was inspired in part by controversial recommendations last month that women undergo fewer mammograms and Pap smears to test for cancer. Republicans seized on those recommendations as early signs of rationing of care they say would happen under the Democrats’ 10-year, nearly $1 trillion health bill.

“The Sen. Mikulski amendment also makes clear, no matter what the Republicans claim, that the decision whether or when to get a mammogram should be left up to the patient and the doctor,” said Senate Majority Leader Harry Reid, D-Nev. “That decision should not be made by some bureaucrat, a member of Congress or someone they’ve never met.”

However the amendment doesn’t specifically address mammograms or spell out what additional services would be covered, leaving that to the discretion of the HHS secretary. The Congressional Budget office said the amendment would cost $940 million over a decade.

Last month, a government-appointed but independent panel of doctors and scientists said women generally should begin routine mammograms in their 50s, rather than their 40s. Then, in an apparent coincidence, the American College of Obstetricians and Gynecologists said that most women in their 20s can have a Pap test every two years — instead of annually — to catch slow-growing cervical cancer.

Neither the task force, which provides advice to government officials who may or may not act on it, nor the doctor’s group sets federal policy.

But the recommendations could not have come at a worse time for majority Democrats, especially Senate leaders trying to hold together the 60 votes required to advance the health care overhaul.

“We know that some in Washington have wanted government-run health care for years. And it’s hard to escape the conclusion that these same people saw the current economic crisis as their moment,” said Minority Leader Mitch McConnell, R-Ky. “Earlier this year, some in the administration said that a crisis is a terrible thing to waste. Americans are hoping this bill isn’t what they meant. But they’re concerned it is.”

The legislative struggle is expected to last for weeks in a test that pits GOP senators determined not to give ground against Senate Democrats intent on delivering on Obama’s signature issue.

The legislation includes a first-time requirement for most Americans to carry insurance, greatly expands the Medicaid federal-state insurance program for the poor, and would require insurers to cover any paying customer regardless of their medical history or condition.

On Tuesday each side sparred over the first of what are likely to be dozens of amendments, with the measures seemingly designed as much to court a skeptical public as to reshape Reid’s 2,074-page bill.

Sen. John McCain, R-Ariz., offered the first GOP amendment, to strip out more than $400 billion in Medicare cuts to home health providers, hospitals, hospices and others — a pitch to seniors, who polls show have deep concerns about the legislation.

“We are receiving incredible and overwhelming response from seniors all over America who feel that the benefits that they paid into are now in jeopardy,” McCain said.

The Congressional Budget Office has estimated that 31 million uninsured individuals would receive insurance if the bill were enacted, many of them assisted by federal subsidies. The legislation would be paid for through a combination of cuts in projected Medicare payments, a payroll tax on the wealthy and taxes on drug makers, medical device manufacturers, owners of high-cost insurance and others.

Associated Press writers David Espo, Laurie Kellman and Charles Babington contributed to this report.